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Homestead_Collins
�!!Dl)�SALES DISCLOSURE FORM SDF ID: Page 2 01157P,REPA RNia • e ` 777r— _ . ..t . - -- .. 'Leon.C.`Stone President Preparer of the Sales Disclosure Form Title 226 West Broadway Street Broadway Title, Inc. Address(Number and Street) Company Princeton, IN 47670 (812)386-1687 City,State,and ZIP Code Telephone Number E-mail Dale Young Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 1804 E Broadway Address(Number and Street) Address(Number and Street) Princeton IN 47670 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct - and complete as"ssreequired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Of ature of leSd r - )/� Signature of Seller Pale Young 1/, as IA Printed Name of Seller Sian Date(MM/an/yin) • Printed Name of Seller Sion Date(MM/Da/rvn7 ryF:IBLiYBR'(S)%G!MIKE(S)SAP,PL GATION F,OR P,RQPERT)Y4AX{DEDUGTIONSTQENiTIFiXJrY llinEMSLITH TtraREY- • ;. ' Stacey L. Collins Buyer I.Name as appears on conveyance document Buyer 2-Name as appears on tonveyanc s nt 720 S Hall Street 4 Address(Number and Street) Address(Number and Street) Princeton. IN 47670 THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL Ob"f�0356.T\lATAPPPbyjhu/y( YES NO CONDITION YES No CONDITION rV COu'Nr1'•YA�lliinlTOR Q ❑ 1.Will this property be the buyer's primary 1Z) ❑ 3. Homestead residence? Provide complete address of primary 0 © 4.Solar Energy Heating/Cooling System residence,including county: 720 S Hall Street ❑ 25.Wind Power Device Address(Number and Street) ❑ IA 6.Hydroelectric Power Device Princeton, IN 47670 - Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ \ 8.Is this property a residential rental property? ❑ 2.Does the buyer have a homestead in Indiana to be .D. • vacated for this residence? If yes,provide ❑ 171 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact information including county: below.Please see instructions for more information. Not available in all counties.) . Address(Number and Street) &l —la —IR— IO1 boo a Qy(I ra O z City,State ZIP Code County Primary property owner contact name E-mail